Vaginal Contraceptive Ring

What is a vaginal contraceptive ring?

NuvaRing is a soft, exible, 5.5 cm diameter clear plastic ring that you insert into your vagina to help prevent pregnancy.

How effective is the ring?

With perfect use, the ring can be 99 per cent effective. There is an increased risk of pregnancy when the ring is not changed every 4 weeks or if it falls out.

How does the ring work?

The ring contains two hormones (estrogen and progestin), which are similar to a womans natural hormones. Hormones are absorbed through the wall of the vagina into the blood stream and stop your body from releasing an egg each month. You cannot get pregnant if your body does not release an egg. You insert and remove the ring yourself. The ring is held in place by the muscles in the wall of the vagina. Most women and their partners do not feel a ring once it is in place. The ring remains in the vagina for 21 days.

How do I start the ring?

Book an appointment with your community birth control clinic or health-care provider to start the ring. To start the ring for the rst time, count the rst day you start bleeding as day 1 of your period. Insert the ring into your vagina during the rst to fth day of this period. The rst month you use the ring, for the rst 7 days you should use an extra method of birth control (e.g. condoms).

How do I use the ring?

Leave the ring in place for 3 weeks (21 days) then remove the ring and wait for 7 days. You will have your period during this 7-day break. You continue to be protected from pregnancy during the 7 days that you are not wearing the ring. Insert a new ring to start the next ring cycle after the 7-day break. After the 7-day break, insert a new ring even if you have not nished your period. You are protected from pregnancy right away when you insert this new ring.

How do I insert the ring?

Wash your hands before and after inserting the ring. Find a comfortable position. Try standing with one foot up on a chair, or sitting with knees apart or squatting down. Squeeze the ring between your thumb and nger. Gently push the folded ring into your vagina. The exact position of the ring in the vagina does not affect the absorption of the hormones in your body. However, the higher the ring is in the vagina the more comfortable it will be and the less likely it will fall out. If you feel discomfort, you probably did not push the ring far enough into the vagina. Gently push the ring further into the vagina with your nger. There is no danger of the ring getting lost inside you or it being pushed too far into your vagina.

Insertion

Removal

How do I remove the ring?

Hook your nger under the rim and pull the ring down and out. Dispose the ring in a covered garbage - away from children and pets. Do not ush the ring down the toilet.

What if I forget to change the ring?

Forget to insert the ring: After the 7-day break - Insert the ring as soon as you remember. - Use an extra form of birth control (e.g. condoms) for 7 days. If you have had unprotected sex during this time, or the extra form of birth control fails (e.g. condom breaks), contact your birth control clinic or health-care provider as you may want to consider emergency contraception, which can prevent pregnancy. After 3 weeks - If the ring has been inside your vagina for 22 to 28 days, remove the ring. - Take the 7-day break and then insert a new ring. You will still be protected from pregnancy. Remove the ring and insert a new one immediately. You will need to use an extra form of birth control (e.g. condoms) for the next 7 days. You may have spotting or miss your period this month. - You may not be protected from pregnancy. If you have had unprotected sex during this time, or the extra form of birth control fails (e.g. condom breaks), contact your birth control clinic or health-care provider as you may want to consider emergency contraception, which can prevent pregnancy.

After 28 days

What do I do if the ring falls out?

A ring may slip out when removing a tampon, having a bowel movement or straining. If the ring falls out within 3 hours: Rinse the ring with cool to luke-warm water and reinsert immediately. You are still protected from pregnancy.

What are the side effects?

There is a small chance (especially in the rst 3 months) that you may have: spotting or bleeding between periods mild headaches, breast tenderness, moodiness, bloating or nausea a slight weight gain or loss increased vaginal discharge or irritation DO NOT STOP USING THE RING - talk with your health-care provider or birth control clinic if you have any of the above side effects

If the ring falls out after 3 hours: Rinse the ring with cool to luke-warm water and reinsert immediately. Once the ring is inserted, it should remain in place for the next 7 days. Use an extra form of birth control (e.g.condoms) until the ring has been in place for 7 days, as you may not be protected from pregnancy. If you have had unprotected sex during this time, or the extra form of birth control fails (e.g. condom breaks), contact your birth control clinic or health-care provider as you may want to consider emergency contraception, which can prevent pregnancy.

Blood clots
In very rare cases, women using the ring may develop a blood clot. Your risk is higher if: you are a smoker you have a family history you have had a blood clot, heart attack or stroke

See your doctor immediately or go to the nearest emergency room if you have any of these symptoms: severe abdominal pain severe chest pain or difculty breathing severe headaches or numbness in arms and legs eye problems such as blurred vision or loss of vision severe leg pain

Important to remember
How to store the ring: - Store at room temperature for up to 4 months. - Use before the expiry date on the product box. - Do not store in direct sunlight or at temperature higher than 30C. - Keep out of reach of children or pets. Your period may be more regular, lighter, and shorter with less cramping. A tampon can be used at the same time as the ring if you have any spotting or bleeding. Prescriptions (e.g. some antibiotics or anticonvulsants) or over-the-counter medication (e.g. St. Johns Wort) may decrease the effectiveness of the ring. Check with your pharmacist to see if your medication affects the ring. You can get pregnant if you do not follow the instructions for using the ring. The ring protects you from certain types of cancer (ovarian and endometrial). The ring does not protect you from sexually transmitted infection (STI).

Sexual decision making

Choose to have sex or not - you have the right to make that decision. Choose to protect yourself from pregnancy and sexually transmitted infection (STI). Use a condom every time you have sex to lower your risk of STI. Talk with your partner about these choices before you have sex.

For more information

Contact your physician, local community health centre or birth control clinic: Calgary: Edmonton: Fort McMurray: Grande Prairie: Lethbridge: Red Deer: (403) 944-7111 (780) 735-0010 (780) 791-6263 (780) 513-7551 (403) 320-0110 (403) 346-8336

Or Health Link Alberta (24 hours a day, 7 days a week) Edmonton, call 408-LINK (5465) Calgary, call 943-LINK (5465) Outside the Edmonton and Calgary local calling areas, call toll-free 1-866-408-LINK (5465) STI/HIV Information Line 1-800-772-2437

SX0041 Jan 2006

Visit: www.health.gov.ab.ca
Thank you to the Contraceptive Health Information Working Group, who developed this resource.